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Mitral valve incompetence: epidemiology and causes

Mitral regurgitation (MR) is the second most frequent indication for valve surgery. Mitral regurgitation may occur for organic or functional causes. The common causes of organic (primary) MR include prolapse syndrome, flail leaflet, rheumatic heart disease, CAD, infective endocarditis, certain drugs, and collagen vascular disease. MR may also occur secondary (functional) to a dilated annulus from dilatation of the left ventricle (from an imbalance between closing and tethering forces) or left atrial enlargement in patients with atrial fibrillation. MR may be acute and severe. Alternatively, MR may worsen gradually over a prolonged period of time and surgery may be necessary by way of mitral…

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 Prevalence of MR

The number of people in the United States with moderate to severe MR is expected to double by 2030. 2% of the U.S. population has primary MR. 1 out of 5 heart failure (HF) patients has moderate to severe or severe secondary MR.

Articles of Interest

About Mitral Valve Regurgitation

In some cases, patients may not be suitable for an open heart procedure to replace the mitral valve and instead will be more suitable to a less invasive treatment option. This new technique involves a specific tool that aims to reduce the amount of backflow (or regurgitation) in severe mitral valve regurgitation.

Management of secondary mitral regurgitation: from drugs to devices

Severe secondary mitral regurgitation carries a poor prognosis with one in five patients dying within 12 months of diagnosis. Fortunately, there are now a number of safe and effective therapies available to improve outcomes.

Mitral valve repair for severe mitral regurgitation: the way forward?

Severe primary mitral regurgitation (MR) has a poor outcome if left uncorrected. Successful mitral valve repair has the unique potential to restore normal life expectancy and is superior to valve replacement. Despite this, mitral repair is performed relatively infrequently and many patients with potentially reparable valves have a replacement instead, subjecting them to unnecessary risk.

Outcome and undertreatment of mitral regurgitation: a community cohort study

In the community, isolated mitral regurgitation is common and is associated with excess mortality and frequent heart failure postdiagnosis in all patient subsets, even in those with normal left-ventricular ejection fraction and low comorbidity. Despite these poor outcomes, only a minority of affected patients undergo mitral (or any type of cardiac) surgery even in a community with all means of diagnosis and treatment readily available and accessible. This suggests that in a wider population there might be a substantial unmet need for treatment for this disorder.

Problem: Mitral Valve Regurgitation

Mild mitral regurgitation often does not have any symptoms. Most symptoms occur gradually and may include coughing, exhaustion, lightheadedness, increased urination at night, rapid breathing or palpitations. As symptoms progress you may have increased shortness of breath with activity, or when lying flat. You also may start waking up more frequently after falling asleep due to breathing trouble.

What is Mitral Regurgitation

One type of mitral regurgitation is called primary mitral regurgitation (also called degenerative). It is caused by an abnormality in the mitral valve itself. Primary MR can be related to age, a valve abnormality present from birth, heart disease, coronary artery disease, or a history of rheumatic fever. The other type is called secondary mitral regurgitation (or functional mitral regurgitation). It is caused by heart disease that leads to an enlarged left ventricle, which prevents the valve from closing properly. This enlarging of the ventricle is most common in heart failure patients.

Resources

Radiopaedia

Mitral valve regurgitation, also known as mitral valve insufficiency or mitral valve incompetence, is a valvulopathy that describes leaking of the mitral valve during systole that causes blood to flow in the reverse direction from the left ventricle into the left atrium.